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NPI Code Detail

MEDICARE: SHANNON GLAGOLA

MEDICARE:   SHANNON  GLAGOLA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1253Z00000XIn Home Supportive Care Agency1828571OH

General Provider Information

NPI Number : 1932715919
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANNON GLAGOLA
Provider Business Mailing Address
First Line : 11401 GOVERNOR AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44111-3675
Country : US
Telephone Number : 216-512-4265
Fax Number :
Provider Business Practice Location Address
First Line : 11401 GOVERNOR AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44111-3675
Country : US
Telephone Number : 216-512-4265
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2020
Last Update Date : 09/16/2020

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Directions to “ SHANNON GLAGOLA ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.